Improving maternal health through more accurate interpretation of lab results
Diagnosing disease and monitoring women’s health during pregnancy requires the accurate interpretation of laboratory test results. Interpretation is done by comparing results to a reference interval – the range of values expected in a representative healthy population.
“Currently, results of laboratory tests for women during pregnancy are compared to reference intervals for non-pregnant females,” says Dr. Vilte Barakauskas, a Clinical Biochemist at the Children's and Women's Health Centre of British Columbia. “Significant physiological changes occur during pregnancy. As such, changes in blood chemistry, immunology or hematology parameters, which are in fact a normal part of pregnancy, may be incorrectly interpreted as ‘abnormal’ and trigger inappropriate further testing or treatment. This may adversely impact both mothers and babies, as well as impacting the health care system.”
Dr. Barakauskas is leading a project, funded by the Canadian Institutes of Health Research, to use provincial data to develop more appropriate reference ranges for women during pregnancy, making for more informed clinical care decisions and improving maternal health care for women across Canada.
“Determining reference intervals in pregnant women is challenging because it is difficult to identify women during early pregnancy, requires blood samples at multiple time points, and requires many participants at each gestational age,” explains Dr. Barakauskas. “This adds complexity, time and cost to prospective studies. Studies utilizing existing data may provide an alternative, and can be achieved by using large volumes of data in laboratory information systems. This approach takes advantage of testing that has already been performed and uses data mining and statistical approaches to identify groups who can represent the reference population.”
Using existing data in laboratory information systems (LIS) in British Columbia, this study will characterize laboratory tests ordered during the course of pregnancy care, to will identify perinatal factors influencing lab test results that need to be accounted for when deriving reference intervals, and will calculate reference intervals throughout the gestational period of pregnant Canadian women.
For the project PopData will link datasets from the BC Perinatal Database, LifeLabs Laboratory Information Systems, the Children’s and Women’s Health Centre of BC Laboratory and the Provincial Maternal Serum Screening database.